The deadly dangers of antibiotic overuse

For decades, doctors and patients have overused, misused and abused antibiotics without much thought, but public health officials are warning that the practice is taking a dangerous, even deadly toll.

“This is a crisis; people are dying,” Dr. Joseph Gastaldo, an infectious disease physician at OhioHealth, said of the rising incidence of antibiotic-resistant infections and superbugs.

Left unchecked, more people will die, and previously treatable diseases could again become untreatable, Gastaldo said.

“We’re already on the verge of having drug-resistant gonorrhea,” he said, as an example.

There’s no question that antibiotics are “wonderful, lifesaving drugs,” Gastaldo said. But because antibiotics can kill “friendly” germs in the body, their use also can have unintended consequences, including leading to other infections, hospitalization or even death.

Each year, at least 2 million people in the United States become infected with antibiotic-resistant bacteria, and at least 23,000 people die as a result, according to the Centers for Disease Control and Prevention (CDC). Many more become ill or die from side effects of the drugs or complications caused by antibiotic-resistant infections.

Consider the case of a 32-year-old mother of two who shows up at the emergency room with appendicitis, said Debra Goff, an infectious disease specialist at Ohio State University’s Wexner Medical Center.

The woman is given a single dose of antibiotics before surgery to prevent bacterial infection and upon discharge, two more prescriptions: one for pain medication, another for a 10-day course of antibiotics “just in case” of an infection, said Goff, a clinical pharmacist.

Five days later, the mother develops severe diarrhea, a common side effect of antibiotics, and by day eight she also has a high fever, acute abdominal distension and severe pain, Goff said. Emergency-room doctors determine she has an infection caused by a type of bacteria called clostridium difficile or C. diff., which can cause symptoms from diarrhea to life-threatening inflammation of the colon. She also is diagnosed with toxic megacolon, a dangerous widening of the large intestine.

“She is taken to the (operating room) and dies,” Goff said. “Death from diarrhea? Every antibiotic carries the risk of C. diff. diarrhea, but this was actually preventable because the 10-day course of antibiotics was unnecessary.”

People who take antibiotics are most at risk of acquiring C. diff. and potentially deadly diarrhea because these medications also wipe out “good” bacteria that protect a healthy person against the infection. Damage to the colon can cause bacteria to leak into the bloodstream.

Antibiotics have been inappropriately prescribed in cases like this for way too long, she said.

At least 30 percent of antibiotics prescribed in doctors’ offices and emergency departments throughout the United States aren’t needed, the CDC reports. A majority are prescribed for respiratory conditions caused by viruses — including bronchitis, common colds, viral sore throats, and sinus and ear infections — which do not respond to antibiotics.

“All antibiotics do is kill bacteria,” Gastaldo said. “They don’t relieve headaches, fever, nausea or any other symptoms of viral infections, and, in fact, could cause harm — when misused.”

That’s why patients should stop demanding them every time they get sick, Gastaldo said, and doctors should stop prescribing them before knowing if they’re needed. “All health-care providers are guilty as charged, including me,” he said.

Children, seniors, pregnant women, cancer patients and other vulnerable populations are at greatest risk of contracting antibiotic-resistant infections, but anyone can be affected, said Dr. Jane Emerick, an infectious disease doctor with the Mount Carmel Health System.

People can protect themselves by staying current on their vaccinations and diligently washing their hands with soap and water whenever they to go to grocery stores, gyms, hospitals, schools or other public places where there are likely to be a lot of germs, she said. They should also avoid sharing personal items with anyone with an antibiotic-resistant infection, such as Methicillin-resistant Staphylococcus aureus, or MRSA, just to be safe.

If people keep getting the same reoccurring infections, they should also talk to their doctor about determining what is causing the infection rather than just asking for an antibiotic for treatment, Emerick said.

Though frequently found in hospitals and nursing homes, antibiotic-resistant bacteria can also strike in the community.

And even more concerning, people can acquire a superbug without even taking an antibiotic, Goff said. That’s because meat producers have been feeding growth-promoting antibiotics to animals for years. If people ingest resistant bacteria via improperly cooked meat and become sick, they might not respond to antibiotic treatment.

To counter concerns, the federal government has been cracking down on antibiotic use in livestock, she said. Health-care professionals, medical systems and patients also are starting to take actions to improve when antibiotics are used on patients and to question when they’re really needed.

New rapid diagnostic tests are allowing doctors to identify the strain of bacterial infection present in a culture and the antibiotics to which it is resistant or susceptible within hours instead of days — allowing for more precise, narrow prescribing of antibiotics, Goff said.

“Antibiotics save lives every day, we just need to make some changes to use them more effectively.” she said.